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A case of pneumoscrotum following spontaneous colonic perforation and mimicking strangulated inguinal hernia.

Mehraeen R, Osia S - Iran J Pediatr (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology.

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We would like to present an idiopathic sigmoid colon perforation revealed with a rare manifestation of pneumoscrotum... His abdomen had distention but was soft and lax, and his scrotum had swelling with red skin that led us into a consideration of strangulated inguinal hernia... A small bubble of gas was seen in the left scrotal region... According to the Rigler's sign, we made a tentative diagnosis of bowel perforation resulting from left sided inguinal hernia... Since 1912 (the first reported case), there are few reported pneumoscrotum due to procedural or pathologic processes... We think that our patient was the first case which reported spontaneous colonic perforation with unknown etiology, which presented with pneumoscrotum during the last decades... Endoscopic (upper and lower) and laparoscopic procedures were the second and third most common causes, respectively... Therefore, as mentioned above, the finding of gas in the scrotal sac may be an early sign of a life-threatening condition like visceral perforation or may represent an incidental finding associated with more benign conditions like laparoscopic procedures... In conclusion, although a combination of free abdominal gas and distended abdomen usually make the diagnosis evident and surgical intervention should be the rule, this case presentation reminds us that eventhough pneumoscrotum is a benign, rare condition, its mere presence should signal the possibility of a severe, life-threatening disease process within the peritoneum like bowel perforation or retroperitoneum like pancreatic or renal abscess.

No MeSH data available.


Abdominal x-ray shows free intraperitoneal gas and Rigler sign (gas in the inner and outer side of the bowel loop- arrow).The open arrow shows gas in the left scrotal sac.
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Figure 2: Abdominal x-ray shows free intraperitoneal gas and Rigler sign (gas in the inner and outer side of the bowel loop- arrow).The open arrow shows gas in the left scrotal sac.

Mentions: Portable CXR was normal but plain abdominal x-ray three hours later revealed bowel distention, specially in the distal colon, with free intra-peritoneal gas (Rigler's sign)(Fig 2). A small bubble of gas was seen in the left scrotal region. According to the Rigler's sign, we made a tentative diagnosis of bowel perforation resulting from left sided inguinal hernia.


A case of pneumoscrotum following spontaneous colonic perforation and mimicking strangulated inguinal hernia.

Mehraeen R, Osia S - Iran J Pediatr (2014)

Abdominal x-ray shows free intraperitoneal gas and Rigler sign (gas in the inner and outer side of the bowel loop- arrow).The open arrow shows gas in the left scrotal sac.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359595&req=5

Figure 2: Abdominal x-ray shows free intraperitoneal gas and Rigler sign (gas in the inner and outer side of the bowel loop- arrow).The open arrow shows gas in the left scrotal sac.
Mentions: Portable CXR was normal but plain abdominal x-ray three hours later revealed bowel distention, specially in the distal colon, with free intra-peritoneal gas (Rigler's sign)(Fig 2). A small bubble of gas was seen in the left scrotal region. According to the Rigler's sign, we made a tentative diagnosis of bowel perforation resulting from left sided inguinal hernia.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

We would like to present an idiopathic sigmoid colon perforation revealed with a rare manifestation of pneumoscrotum... His abdomen had distention but was soft and lax, and his scrotum had swelling with red skin that led us into a consideration of strangulated inguinal hernia... A small bubble of gas was seen in the left scrotal region... According to the Rigler's sign, we made a tentative diagnosis of bowel perforation resulting from left sided inguinal hernia... Since 1912 (the first reported case), there are few reported pneumoscrotum due to procedural or pathologic processes... We think that our patient was the first case which reported spontaneous colonic perforation with unknown etiology, which presented with pneumoscrotum during the last decades... Endoscopic (upper and lower) and laparoscopic procedures were the second and third most common causes, respectively... Therefore, as mentioned above, the finding of gas in the scrotal sac may be an early sign of a life-threatening condition like visceral perforation or may represent an incidental finding associated with more benign conditions like laparoscopic procedures... In conclusion, although a combination of free abdominal gas and distended abdomen usually make the diagnosis evident and surgical intervention should be the rule, this case presentation reminds us that eventhough pneumoscrotum is a benign, rare condition, its mere presence should signal the possibility of a severe, life-threatening disease process within the peritoneum like bowel perforation or retroperitoneum like pancreatic or renal abscess.

No MeSH data available.